This invention relates to the field of therapy and rehabilitation for neural degeneration. This invention is also related to at-home rehabilitation and therapy for improvement of synaptic plasticity in multiple sclerosis patients.
Multiple sclerosis (MS) involves the degradation of a patient's brain networks via demyelination. The patient's immune system attacks the central nervous system, breaking down the fatty myelin sheath which protects a nerve fiber. Myelin breakdown (demyelination) disrupts a nerve's action potential—its fine-tuned ability to receive and convey a stimulus. Disruption of the action potential results in disruption of synaptic plasticity—the ability of synapses to strengthen or weaken over time.
Synaptic plasticity is highly sensitive to action potential timing. The difference between 10 and 50 milliseconds in action potential can be the difference between long term potentiation (strengthening) and long term depression (weakening).
Some options available to patients suffering from decreased synaptic plasticity include brain training and rehabilitation. Unfortunately, the effectivity of brain training has not been conclusively established. Traditional rehabilitation techniques, on the other hand, are expensive and require the intervention of professionally trained therapists and medical professionals.
Existing methods specifically target plasticity to treat neurological disease. Deep brain stimulation, transcranial magnetic stimulation, optogenetic stimulation, or intensive repeated training could potentially trigger sufficient neuromodulatory release during experience to induce therapeutic plasticity.
Furthermore, stimulation of the vagus nerve paired with behavioral experience may also drive specific forms of neural plasticity. Vagus nerve stimulation (VNS) engages multiple neuromodulatory systems and can be precisely temporally controlled. Additionally, VNS is a safe and approved method currently being used in over 60,000 patients for management of intractable epilepsy and depression. Recent studies have demonstrated that VNS paired with sensory, motor, or cognitive training can drive specific forms of cortical plasticity that result in behaviorally relevant changes. As a result, VNS applied as a targeted plasticity therapy offers the potential to treat sensory, motor, and cognitive dysfunction.